This is not a record of a planned research
carried out as a whole time occupation: it is the
record of investigations made, during a tour of duty
as a Medical Specialist in the Royal Army Medical
Corps in East Africa Command, in an attempt to answer certain questions which forced themselves upon my notice.
The literature dealing with Tuberculosis in
East African natives is scanty and with one or two
exceptions pessimistic. It was the realization than
this pessimism was not entirely justified that gave
the initial stimulus to these investigations.
Critical revision of t he case notes has revealed two major deficiencies: the routine investigations were not always made as regularly as they
should have been and in some cases the treatment
given was ill-advised. The irregularity of the
routine investigations was due to pressure of other
more urgent work. During the period in question
there were two major outbreaks of Falciparum Malari
and an epidemic of Typhoid Fever. During these outbreaks so much additional work was thrown upon the laboratory staff that routine investigations on
chronic cases had to be deferred. The errors in
treatment were due to ignorance on my part - an
ignorance which it Was the main purpose of this
investigation to rectify.
East African Natives suffering from Pulmonary
Tuberculosis can obtain specialist treatment at three centres: Kibongoto Sanatorium, Tanganyika Territory; the Hospital f or Chest Diseases, Mombasa, Kenya: and
Mulago Hospital, Kampala, Uganda. I was able to visit each of these hospitals and it was encouraging to find that a reasonable optimism prevailed at them all.
No account of these investigations would be
complete without acknowledgement of the help so freely
given to me on all sides. The East African native
dislikes lying in bed. The Nursing Officers of Queen
Alexandra's Royal Army Nursing Corps, who were in
charge of the Tuberculosis wards, were indefatigable
in their efforts to enforce strict rest in bed.